Long-term childhood outcomes for babies born at term who were exposed to antenatal corticosteroids


      Antenatal corticosteroids improve neonatal outcomes when administered to infants who are at risk of preterm delivery. Many women who receive antenatal corticosteroids for threatened preterm labor proceed to deliver at term. Thus, long-term outcomes should be evaluated for term-born infants who were exposed to antenatal corticosteroids in utero.


      This study aimed to compare long-term outcomes between term-born children aged ≥5 years who were born to women who received antenatal corticosteroids for threatened preterm labor and children whose mothers were also evaluated for threatened preterm labor but did not receive antenatal corticosteroids.

      Study Design

      We performed a retrospective cohort study of children born at ≥37 weeks’ gestation, aged ≥5 years, and born to mothers diagnosed with threatened preterm labor during pregnancy. The primary exposure of interest was receiving antenatal corticosteroids. Among the collected childhood medical conditions, the primary outcome of interest was a diagnosis of asthma.


      Of the 3556 term-born children aged ≥5 years, 629 (17.6%) were exposed to antenatal corticosteroids (all betamethasone), and 2927 (82.3%) were controls whose mothers were evaluated for threatened preterm birth but did not get antenatal corticosteroid injections. Women receiving antenatal corticosteroids had higher rates of maternal comorbidities (diabetes mellitus, hypertension; P≤.01). Antenatal corticosteroid-exposed children had no difference in diagnosis of asthma (12.6% vs 11.6%), attention deficit disorder, or developmental delay (P=.47, .54, and .10, respectively). Controlling for maternal and neonatal characteristics, asthma was not different between those exposed to antenatal corticosteroids and controls (odds ratio, 1.05; 95% confidence interval, 0.79–1.39). The odds of the child’s weight percentile being <10% were increased for antenatal corticosteroid-exposed children born at term (odds ratio, 2.00; 95% confidence interval, 1.22–3.25).


      Children born at term who were exposed to antenatal corticosteroids may have increased odds of being in a lower growth percentile than those not exposed. However, rates of diagnoses such as asthma, developmental delay, and attention deficit disorders were not different.

      Key words

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      Linked Article

      • A dilemma of antenatal corticosteroids for long-term consequences
        American Journal of Obstetrics & GynecologyVol. 228Issue 1
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          Antenatal corticosteroids (ACS) are known to accelerate fetal lung maturation and prevent preterm neonatal mortality, respiratory distress syndrome, and brain injury. The American College of Obstetricians and Gynecologists has expanded its recommendations for the use of ACS to late preterm and early term deliveries.1 Under such guidelines, the proportion of infants who are exposed to synthetic corticosteroids has substantially increased. In the setting of a large infant population being involved, it is imperative to evaluate the long-term safety of ACS, especially after a population-based cohort study that reported a hazard ratio of 1.47 of any mental or behavioral disorder in children born at term who were exposed to ACS.
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